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Adverse cardiac events in patients with coronary stents undergoing noncardiac surgery: a systematic review
- Source :
- The American Journal of Surgery. 204:494-501
- Publication Year :
- 2012
- Publisher :
- Elsevier BV, 2012.
-
Abstract
- Background When patients with drug-eluting stents (DES) present for surgery, current guidelines recommend delaying elective surgeries until 1 year of dual antiplatelet therapy has been completed. Methods We performed a systematic literature review of the major adverse cardiac events (MACE) associated with noncardiac surgery in patients with DES. Results Twenty-eight of 358 studies met inclusion criteria. Overall, MACE rates decreased as time to surgery increased and varied from 0% to 18% for surgeries within 1 year as compared with 0% to 12% for surgery more than 1 year after a stent. In addition, the current literature showed limited evidence for a protective effect of continuing perioperative dual antiplatelet therapy on MACE rates. Conclusions The current literature supports a significant decrease in MACE when surgery is performed 1 year after DES placement; however, the level of evidence is weak. Larger studies are needed to determine the safe interval for surgery after stent placement.
- Subjects :
- medicine.medical_specialty
Time Factors
medicine.medical_treatment
MEDLINE
Risk Factors
Coronary stent
medicine
Humans
cardiovascular diseases
business.industry
Coronary Thrombosis
Stent
Drug-Eluting Stents
General Medicine
Evidence-based medicine
Perioperative
Surgery
Systematic review
Elective Surgical Procedures
Drug-eluting stent
Surgical Procedures, Operative
Anesthesia
business
Platelet Aggregation Inhibitors
Mace
Subjects
Details
- ISSN :
- 00029610
- Volume :
- 204
- Database :
- OpenAIRE
- Journal :
- The American Journal of Surgery
- Accession number :
- edsair.doi.dedup.....9401ef0d1cea7735de8c476878517533